The Positive Place HIV and mental health Gus Cairns

Introduction to course Aim of training To educate and inform volunteers about aspects of HIV and mental health To help you discuss own experiences of dealing with clients with mental health and emotional support issues To do some elementary experiential training to help volunteers deal with and relate to people with specific emotional support needs

What this course is NOT A therapy workshop Scary or distressing Has boundaries

Exercise: non verbal communication and boundaries Stand up Mingle round the room Find a way to say hello to each person WITHOUT SAYING A WORD Find a safe way to make physical contact with each other – anything from a fingertip touch to a hug – but CHECK IT OUT with the other person non-verbally before doing anything

Introduction to people! Me: why interest in mental health? You: –Name –Where you came from today –Where you originally come from –Why you work in HIV –One thing you like doing that’s nothing to do with HIV

List of words/associations with mental illness ……flipchart exercise

Pair exercise “My bad day, and what I did about it”

A side-journey into STRESS “The state arising when the individual perceives that the demands placed on them exceed (or threaten to exceed) their capacity to cope, and therefore threaten their wellbeing.” Stress is not mental illness Normal part of life Physical effects Depends what you do with it Stress scale

StressEvent value Death of spouse100 Divorce60 Menopause60 Separation from living partner60 Jail term or probation60 Death of close family member other than spouse60 Serious personal injury or illness45 Marriage or establishing life partnership45 Fired at work45 Marital or relationship reconciliation40 Stress scale top 10

Why mental health is important in HIV

HIV issues Physical: HIV illness, dementia Drug side effects New diagnosis Stigma and isolation Long term survivors: ‘Lazarus effect’: I’m not special any more Work and career Loss and bereavement Sex and love Body changes Life issues that may have let to HIV: depression, addictions, abuse

How common I: North Carolina

How common II: London 2002

STRESS BREAK!

Definitions, definitions… Organic: dementia Psychosis Neurosis Personality disorder

The five primary emotions - EXERCISE Happiness Anger Fear Sadness Confusion

What do you do with them? See which box is fullest See which box is most empty You may have most problems with the emptiest box So may people with mental health problems

Five primary emotions - stuck Sadness stuck is ? Fear stuck is ? Happiness stuck is ? Anger stuck is ? Confusion stuck is?

What we notice… Appearance/behaviour: unkempt, restless, eccentric Rapport: are they with you? Speech: slow, fast, easy, reluctant, comprehensible Mood: euphoric, depressed, anxious, irritable, labile, blunted, incongruent Thought: block, incoherence, delusion, obsession Cognition: ability to understand and have concepts Body and perception: dizzy, spaced-out, cold sweat, heart, headache, noise Insight: self-awareness, including the awareness that something is wrong (if it is)

LUNCH BREAK!

Depression and its risk factor, suicide A story…Mr P Inner experience and meaning of depression: shutdown Language to watch out for: overt/sleep/going away/switch off/can’t cope Depressed people are helpless, hopeless…and annoying! How NOT to help a depressed person

Anger and its risk factor, violence A story…Dave Inner meaning and experience: frustration and isolation Language and behaviour to watch out for How NOT to handle angry clients

Anxiety and its risk factor, panic A story…the phone call Inner meaning and experience of anxiety states: the adrenalin trap Fight, flight – and freeze How NOT to help anxious clients

Bully/victim/rescuer The roles people play… …and the roles they try to get you to play

Boundaries and confidentiality The client who wants to be your friend The client who tells you shocking things When to break confidentiality

Role plays

Feedback and evaluation